September 5, 2011

Host: Karen Stollznow

John Dodes is a dentist with a special interest in dentistry and pseudoscience. He is one of the founding fellows of the Institute for Science in Medicine, a former President and Chairperson of the National Council Against Health Fraud, and a member of the Health Fraud Advisory Council. He is also a member of the American Council on Science and Health, and the Dental Consultant to Quackwatch.org.

John has written about alternative therapies and myths about dentistry for Skeptical Inquirer magazine and many other publications. He is the author of the books The Whole Tooth and Healthy Teeth - A User's Manual. In this interview with Karen Stollznow, John talks about evidence-based dentistry and the inadequate teaching of the scientific method to students of dentistry. He reveals some of the hazardous practices of "Holistic Dentistry", and the integrative use of chiropractic, kinesiology and homeopathy.

John clears up some classic dental myths and misconceptions—is the fluoridation of our water supplies safe? Are we being poisoned by our amalgam fillings? He also discusses some paranormal dental claims; that psychic dentists can fix cavities, and that God can turn fillings into gold.

Lastly, John explains how to avoid dangerous practitioners and treatments and provides advice for consumers to make the best choices about dental healthcare.

I enjoyed this interview tremendously and was agreeing with Dr. Dodes at every point until he talked derisively about “a piece of plastic” to treat TMD. I would like him to look into the research and career of Glenn Clark, DDS, at USC. Here is a link:http://www.usc.edu/hsc/info/pr/hmm/08summer/facultyspotlight.html
I grew up with Glenn as an honorary family member. We are extremely proud of him. I just don’t believe he is unscientific in his practice. I know that he has made a comfortable income at both UCLA and USC, but if he were in this for the money, wouldn’t a lucrative private practice have been his choice? My small understanding of the roll of that “piece of plastic” is to prevent tooth damage due to teeth grinding while the patient is asleep. That doesn’t sound like quackery to me.
I unfortunately wore braces as an adult to help TMD. When I talked to Glenn about this, he said, “I hope you were trying to straighten your teeth.” I could tell that he thought it was a waste of time and money to treat TMD with braces-and he was right.
So, Dr. Dodes, please take a look.

Great interview, but I was a little disappointed that Dr. Dodes didn’t directly address the specific concerns of the anti-fluoride movement preferring instead to take a vaguely dismissive tone. Anti-flouridaters have been told that fluoride is a highly toxic substance that had industrial uses such as in pesticides before it’s use as a treatment to prevent tooth decay. They have been told that it was banned before the government was convinced by industrial lobbyists and some scientists in their pocket.

To merely take a mocking tone by saying, and I’m paraphrasing, ‘Well, some people still believe the earth is flat’, will do nothing to address their concerns, scientifically uninformed or easily misled though they may be.

If your intent is to convince people that their deeply held belief is unwarranted, then you have to take on the information that they have been fed. Otherwise, it all comes off as dueling propaganda.

I want to apologise to Janiceevalyn for not making my self clearer. I actually know Glen and regard his research as absolutely first rate. I meant to say that plastic appliances that are used to treat facial pain have not been proven as effective and that those appliances that cover only some of the teeth, so called MORA appliances (mandibular orthopedic repostitioning appliances) can cause great harm. I was not referring to night-guard type appliances that are worn at night cover all the teeth in one arch and are very useful for preventing tooth wear. I should have been more precise.

I appreciate all the nice comments and hope that the information helps the public stay healthy.

I enjoyed the interview but I have to say as a new dentist and also a skeptic I found there was some inaccurate information that Dr. Dodes gave regarding dental school education. I don’t think its hardly as grim with regard to quackery taught in dental school as he said. My experience was quite the opposite. I went to dental school in Arizona, which is one of the newer schools in the country, and I can’t stress enough how much emphasis they placed on practicing evidence based dentistry in our curriculum. Also, I have friends all over the country that are either in dental school now or have recently graduated and I can tell you none of them are being taught chiropractic medicine or acupuncture - that would be laughable at most schools. These courses may be taught in continuing education but its not as mainstream as he made it sound. I’m curious where he is getting this information and what schools this is being taught in.

to accidental: ebd is not the same as scientific method. ebd is a way to get information but not a way to evaluate and think. it is certainly heartening to hear about your experience but most dental school learning is still “authoritarian”. I wonder how many experiments you did to test such things as cavity design, abfractions, muscle strength and jaw position, mercury leeching from amalgams, etc. Did your teachers ever taken an article from a major dental/medical journal and dissect it, looking carefully at the statistics, randomness, etc? I am in touch with many dentists and feel that I am correct in my criticism of dental education. In addition, when I take post-graduate dental courses on pseudo-scientific subjects there are many young dentists in attendance who do not seem at all concerned by the lack of science. Take a close look at the courses being offered and at the exhibit booths at major dental meetings and you’ll find a number of questionable theories - in my opinion - even one is too many if it’s offered for credit or given the imprimitur of a dentistry-sponsored convention. I hope you’ll continue to be skeptical (even of me). It is my hope that better dental education will lead to better dentists who are less apt to adopt quack therapies. Congratulations on being a dentist, it’s a great profession and one I’ve enjoyed for 40 years.

to accidental: ebd is not the same as scientific method. ebd is a way to get information but not a way to evaluate and think. it is certainly heartening to hear about your experience but most dental school learning is still “authoritarian”. I wonder how many experiments you did to test such things as cavity design, abfractions, muscle strength and jaw position, mercury leeching from amalgams, etc. Did your teachers ever taken an article from a major dental/medical journal and dissect it, looking carefully at the statistics, randomness, etc? I am in touch with many dentists and feel that I am correct in my criticism of dental education. In addition, when I take post-graduate dental courses on pseudo-scientific subjects there are many young dentists in attendance who do not seem at all concerned by the lack of science. Take a close look at the courses being offered and at the exhibit booths at major dental meetings and you’ll find a number of questionable theories - in my opinion - even one is too many if it’s offered for credit or given the imprimitur of a dentistry-sponsored convention. I hope you’ll continue to be skeptical (even of me). It is my hope that better dental education will lead to better dentists who are less apt to adopt quack therapies. Congratulations on being a dentist, it’s a great profession and one I’ve enjoyed for 40 years.

Thanks for the reply Dr. Dodes. One of our courses was called EBD and it required us to analyze many journal articles. We also had a few guest lecturers speak on the topic as well. Your are correct we did not do any studies like that in school however many of my classmate were involved, as a part of their summer interns, in large dental related studies all over the country but it was up to us to find opportunities like that. So by the time they finished school they could put on their CV’s that they were ‘published’. I thought that was pretty cool and exposed them to scientific method. At any school cost is going to be an issue for incorporating any studies actually into the program and I’m not all that sure that is the place for it. I don’t think that’s necessary to teach critical thinking, although it would help. I think schools are more concerned about producing competent clinicians that aren’t going to harm the public with a drill in their hand.

I really really loved the interview!! I had no idea there was so much pseudoscience and stuff in dentistry and it fascinates me and horrifies me. I will be more skeptical of my dentists from now on. I too, as soon as you said in the interview that one should never be told to wear plastic between their teeth, thought of my mouth guard that I wear nightly to protect myself from grinding - my father and his sister wear them too. But I listened and could tell you were talking about if you have face pain because of jaw joint problems the plastic won’t solve it. You never once said mouth guards are quackery and so I assume they are scientifically backed up as good. I am pretty sure, at the very least, that it’s not hurting me.

I’m only 21 years old and I do have a vague memory of once being told I had a cavity or cavities or something, and that I needed a filling… and then they did something to my mouth and said they put sealants on or something… but it was super quick and painless and there was nothing in my mouth. Nothing noticeable. I thought back then as a child that something was fishy about that but never said anything. It’s possible my parents were charged money when the dentist did absolutely nothing to fix a problem they’d invented. I’ve never had a cavity other than him claiming I did that one time.

Dr. Dodes, you seem amazing and smart and I’m so glad you’re on our side, fighting the good skeptical battle.

I was intrigued to listen to this interview about pseudoscience in dentistry. I have had a question for several months now that I tried searching on my own (I’m not totally without tools, having earned a PhD in physical chemistry I know how to do a literature search and critically read papers) and asking skeptical friends but no one seems to be able to answer. I would appreciate it very much if Dr. Dodes could shine some light on it for me.

An orthodontist recommended us to a myofunctional therapist for my daughter. The therapist had several articles to back up her claims of how it would help my daughter’s mouth and jaw. At least one or two appeared in, near as I could tell, peer-reviewed journals. It sounds suspiciously like woo but could be something I’ve never heard about before.

So my question is: is myofunctional therapy quackery?
Thank you for your time.

An excellent interview! It was very helpful to hear of warning signs of dental quackery. I guess I should have been alarmed many years ago when my dentist suggested removing all of my metal fillings and replacing them with new fillings, crowns, or bridges as needed for each situation. But the fact is, these fillings were 15 to 20 years old at the time, and they were starting to crumble and fall out on their own. Over several visits, my dentist replaced all the fillings with new work as we discussed, and the annoyance of little balls of metal in my mouth ceased. I think he did a good job and it was a job that had to be done.

Why do I bring this up?

Because not every case of a dentist recommending lots and lots of work is quackery. In this case, the work was necessary.

Next time, though, that a dentist recommends a lot of work, I’ll seek a second opinion from a dental school. That’s some good advice I learned from this podcast. Thanks!